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' -41).1\10 <br /> O�T City of Orono �F�C �UfSE ONLY��, / ��/95 <br /> 1 V P.O. Box 66 Date Received?/�f Permit# `f 7` <br /> 0 (9 50 Kelley Parkway <br /> s. Crystal Bay,MN 55323 Amount: $ 55 a' SAC Credit: <br /> (952)249-4600 �'�� i' <br /> Homeowner(s)Signed: 0 Yes <br /> F �,� Resolutions(if any)Signed:0 Yes 0 None Required <br /> `�'�ESHo' ' Zoning Disclosure Signed: 0 Yes 0 None Required <br /> CITY OF ORONO - DEMOLITION PERMIT <br /> (All permits must be approved by the Building Official and/or Zoning Department) <br /> I Job Site/ Owner information: <br /> Type: X Residentiallr] Commercial <br /> Site Address: '7/00 rL [� <br /> Q`7 J 7r <br /> Owner: /ffonAS 4r5 iP €&$t L Mailing Address: y/00 CC.A 57 <br /> City: O&M 0 Zip: 5-3.S( <br /> Phone: 9507' 1-i7� ' 826 ? Email: IC j6ad7/L (@ Ma dri <br /> Contractor/Applicant Information: <br /> Contractor/App.: Contact Person: <br /> Address: State License#: <br /> City: Zip: Expiration Date: <br /> Phone: Email: <br /> SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT <br /> General Instructions: <br /> 1. You may be required to obtain other permits, i.e.: well abandonment, sewer, etc. <br /> 2. Work must not begin unless the permit card is available on the job site. <br /> 3. A 24-48 hour notice is required for all inspections. Call (952) 249-4600. <br /> 4. Sewer must be discontinued at the City service by qualified contractor before demo permit is <br /> issued. <br /> Demolition by means of: 1 Manual Disassembly ❑ Heavy Equipment ❑ Other <br /> Permit(s) Issued: ❑ Sewer Disconnection ❑ Well Abandonment# <br /> In return for issuance of said Demolition Permit, the undersigned owner hereby agrees to: <br /> 1. Submit a survey, aerial photo or sketch showing all structures on the property. Note which <br /> structures are to be demolished. <br /> 2. Submit a survey, aerial photo or sketch showing proposed erosion control measures in <br /> accordance with Chapter 79, Construction Site Runoff Control. <br /> 3. Submit a copy of permit approval from the Minnehaha Creek Watershed District (MCWD). The <br /> City will not issue a demolition permit without a copy of the permit(s) from the MCWD or <br /> documentation stating permit(s) are not required. <br />